An integrated health campaign for Togo’s children

Women gather to register their children during the nationwide integrated immunization campaign, in the town of Kpalime, Togo.

LOME (Togo), 8 March 2005 — In an unprecedented all-in-one campaign last December, nearly one million children in Togo benefited from a new type of health campaign aimed at reducing child deaths in Africa.

The integrated campaign reached 97 per cent of children between 9 and 59 months in the country with four health interventions at once: vaccines to prevent measles and polio, mosquito nets to prevent malaria and deworming tablets to treat intestinal worms.

“It’s a new approach and it’s a real challenge, but we believe that this integrated approach will have a significant impact on reducing child deaths,” said UNICEF Representative Aicha Diawara Flambert.

Four-year-old Afi and her mother were among the first to arrive at the Foyer Pie XII vaccination post in the capital Lome.

In less than five minutes, the young girl received deworming medicine to expel intestinal worms; two drops of polio vaccine; a shot to protect against measles; and a long-lasting insecticide-treated mosquito net to use every night at home to prevent malaria.

More than 4,000 volunteers and health workers were recruited in over 1,000 sites across the country to reach all children between 9 and 59 months. Mobile teams were also deployed to reach children living in remote, hard-to-reach areas.

A woman health worker prepares to give a measles vaccination to a toddler girl held by her mother, at an outdoor health post in Kpalime, Togo.

The vaccination post of Kpalime, about 100 kilometers from the capital, was bustling with energy on the first day of the campaign. Early that morning, hundreds of parents and their children had already formed a long line, protected from the sun under a big tree.

Piles of mosquito nets were everywhere. The free distribution of insecticide-treated mosquito nets is a big draw for parents, who often cannot afford to pay the 2-3 dollars required to buy one.

UNICEF Health Chief Pascal Villeneuve, who had flown from New York the day before, was there early to observe the preparations.

“It’s important that these types of strategies take place in Africa; it’s important that these strategies include interventions that are going to have an impact on the biggest child killers in Africa: measles and malaria,” said Villeneuve.

In Togo, malaria is a year-round problem that threatens the entire population. It is responsible for thousands of deaths each year and 40 per cent of public health expenditure. Many of these deaths could have been prevented through the use of a long-lasting insecticide-treated net (LLIN).

Four-year-old Afi and her mother are among the first to arrive at the ‘Foyer Pie XII’ vaccination post in Lome, the capital of Togo.

Yet in 2003, only 15 per cent of Togolese children under-five slept under a mosquito net and barely 2 per cent slept under a LLIN. To date, poverty has been a major barrier to net ownership. Even though the average price of a net is only about US$ 2 to US$ 5, it is still beyond the reach of poor households.

Despite improvements in routine immunization coverage almost half of Togo’s children born since 2001 are still at risk from measles – a completely preventable disease that affects over 30million children each year and kills over 540 000 worldwide.

UNICEF believes that integrated campaigns like this one may become the most important step towards reducing child mortality.

“This is the best Christmas present for children in this country,” said Togo’s Minister of Health Suzanne Aho at the launch of the campaign in Lome.“But we must protect all children in Africa, not just the children of Togo. It is important for all of Africa.”

More than US$ 5.4 million has been spent on the campaign of which almost US$ 790 000 has been raised by UNICEF and WHO, through the support of international partners including the UN Foundation, the US Centers for Disease Control and Prevention, the American Red Cross, the Canadian Red Cross, the Norwegian Red Cross, the Canadian International Development Agency and the International Federation of Red Cross and Red Crescent Societies (IFRC).